Heart Rate, or pulse, is the speed or number of times the heart beats (measured by the number of contractions of the heart) per minute. It can be detected in areas of the body where the artery is close to the skin: the palm side of the wrist, side of the neck, groin, back of the knee, or top of the foot. In healthy adults, a resting heart rate is between 60 and 100 beats per minute, however, in conditioned athletes, it is often well below 60. When the heart rate is not within normal parameters, it can be an indication of what is happening around you…fear, anxiety, fatigue, contentment, or a medical problem.
The first step to determine the status of your heart rate (HR) is to measure your resting heart rate. A normal resting heart rate for a healthy adult is between 60 and 100 beats per minute. The best time to measure it is immediately after you wake up in the morning before you get out of bed (or when sitting and relaxing). Place your index and middle fingers on the side of your neck or on the palm side of your wrist. Then, count the number of beats you feel for 60 seconds.
Whether you determine that your HR is too high or too low don’t panic. Take your HR repeatedly and document results so you can discuss it with your primary care physician. It is not unusual to find a wide range of numbers which varies individually. For example, it is not unusual for a conditioned athlete (marathon runner) to have a resting HR of mid to high forties or low fifties. More common in the general population, however, is a high resting HR and this can be an indication of a potential health problem. When your resting HR is high it indicates that your heart is working harder than it needs to…especially if you are at rest! Remember, your heart is a muscle and it doesn’t work very efficiently when it is deconditioned…it has to work harder than it should to pump blood through your body, even at rest!
All is not lost! The good news is that you can lower your resting heart rate and improve heart health with a few lifestyle changes.
Probably the best way to lower your resting HR is to avoid a sedentary lifestyle and get moving. Inactivity leads to a downward spiral of poor health …obesity and its associated problems of high blood pressure, and diabetes.
Remember, you don’t have to run 26.2 miles to be fit and healthy. The American Heart Association recommends 150 minutes of moderate-intensity aerobic exercise per week. And, it can be broken down into 10-15-20 minute sessions once, twice or three times per day.
The negative impact of stress and anxiety on health and wellness is well document. While avoiding stress may not be possible, one can learn to manage it. Exercise is one effective way but there are others. Meditation, breathing exercises and yoga are a few. Visit a YouTube video on Progressive Muscle Relaxation (PMR).
Caffeine and nicotine are stimulants and can raise your heart rate.
Losing weight will lower your HR. A healthy diet that maintains a body mass index (BMI) between 18 and 25 for adults is an essential component to a lower HR and overall good health. A BMI over 25 is considered overweight and over 30 obese. Use the BMI calculator from the CDC at: www.cdc.gov>adult_bmi
Dehydration can lead to thicker blood. Thicker blood requires the heart to work harder to circulate blood throughout the body. Drinking plenty of water, (15.5 cups for men and 11.5 cups per day for women), will adequately hydrate the body.
For many, getting 8 hours of sleep per night is easier said than done. But, adequate sleep contributes to overall good health and a lower heart rate.
Lowering your resting heart rate is an essential component to good health. The steps necessary to attain a lower heart rate such as exercise, eating healthy, maintaining a healthy BMI, hydrating, and getting adequate sleep will also contribute to overall physical and mental health and wellness. Discuss how you might begin your journey to a healthier lifestyle with your primary care physician or health care professional.
SOURCES: Cleveland Clinic; Johns Hopkins University, Centers for Disease Control
Read Dr. Mackarey’s Health & Exercise Forum – Every Monday
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
Whether you are a student, athlete, or just trying to live a healthy life, we could all benefit from a routine of adequate sleep. However, according to the Centers for Disease Control and Prevention, 1 in 3 American adults get less than seven hours per day, which is the recommended amount to maximize wellness. William Dement, M.D. argues in his book, The Promise of Sleep, that our patterns of rest are the single most important determinant of our length of life. But what is a “healthy” sleep schedule? It turns out that while inadequate sleep is common in the US, there can indeed be too much.
The National Sleep Foundation (NSF) has recommendations depending on your age group. The average for adults is 7-9 hours. As you get older, they recommend a shorter amount of time needed for sleep each night. However, they urge each person to reflect on how they feel each day and adjust their habits accordingly.
If you are one of the 33% of Americans not getting enough sleep you have probably tried or are willing to try anything to avoid staring at the ceiling for hours before falling asleep. For these unfortunate people, the moment the lights go off, their brain switches on…tossing and turning, wrestling and twitching until they reach exhaustion. One new product that has been receiving plenty of attention is a weighted blanket.
While sleeping with a weighted blanket may seem a little extreme at first, many believe that sleeping with the equivalent of a 30 pound toddler evenly distributed across their body, is very effective in calming anxiety, promoting relaxation and sleep.
A weighted blanket is filled with plastic pellets or glass beads that add weight to the blanket. These blankets range in weight from five to 30 pounds. The sensation is similar to the lead vest worn during dental x-rays and the extra weight provides deep pressure to relieve anxiety and reduce insomnia.
Choosing the optimal weight or type of blanket is not an exact science. Manufacturers recommend adults use a blanket that is equal to 10% of their body weight. The filler determines the thickness and texture. Glass beads are smaller and produce a thinner blanket as compared to plastic pellets.
For those concerned with temperature, some blankets use bamboo as a cover for cooling, while others offer additional filling for warmth.
The theory behind the use of weighted blankets for anxiety and insomnia rests on previous research related to deep pressure stimulation…gentle pressure applied over the entire body (like being wrapped in a swaddle or sharing a prolonged hug).
The concept of deep pressure for stress and anxiety reduction is not entirely new. Occupational therapists working with children with autism spectrum disorders have used deep pressure to promote a calming and relaxing effect.
Research supporting the efficacy of weighted blankets is limited and varied. While some studies suggest weighted blankets offer promise for those suffering from anxiety, far less support their effectiveness for insomnia.
One study of 32 adult volunteers, reported 63% lower levels of anxiety after lying under a 30 pound blanket for 5 minutes. In another study, 30 participants who were hospitalized for a mental health crisis demonstrated 60% reduction in anxiety after using the blanket.
Luxome: Made from bamboo and hypoallergenic glass beads with fibers known for moisture-wicking and cooling. Rated #1 with 6,000 five-star Reviews. $119.99 (luxome.com)
Layla: Made from high density micro glass beads with cotton, polyester and mink outer materials. Sized for one or two people. $129.00 (queen size) (laylasleep.com)
YNM: Made from bamboo and hypoallergenic glass beads. Sized for one or two people. $79.90 (amazon.com)
Reviews: While the research may be lacking, the testimonials and customer product reviews are very favorable for satisfaction, durability and effectiveness.
It may be too early to tell according to the scientific literature. However, there is some indication that weighted blankets may reduce anxiety in some. It is less certain that these blankets will reduce insomnia. There are no studies that indicate that weighted blankets are harmful and may be worth a try for those who have exhausted more traditional options for anxiety and insomnia as a replacement or adjunct.
Read Dr. Mackarey’s Health & Exercise Forum – every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
See all of Dr. Mackarey's Articles at https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
I enjoy the privilege of working with people recovering from a wide variety of medical conditions. Many of these conditions can directly affect activities of daily living, particularly, the ability to drive safely: orthopedic and sports injuries, fractures, sprains and strains, joint replacements, hip fractures, shoulder and elbow surgeries and spinal fusions. Despite the many different types of problems, there is one question that is invariably asked, “When can I return to driving?” Unfortunately, the answer is not as simple as the question because it depends on many factors. Furthermore, the implications, such as a serious accident causing further damage to the injury or surgical site or harm to someone else, are significant and possibly critical. So, the next time you ask your physician this question, please follow instructions and be patient…remember, it could be your child or grandchild running into traffic to chase a ball and you would want the driver to be at optimal function to apply the brakes!
In our culture, the inability to drive has a significant impact on lifestyle and livelihood. A study published in the Journal of Bone and Joint Surgery, found that 74% of those unable to drive due to injury or surgery are dependent on family and most of the remainder depend on friends. 4% of those unable to drive have no help at all and more than 25% suffer major financial hardship.
The report also found that family physicians, orthopedic surgeons, podiatrists, and physical therapists are keenly aware of this dilemma but often fail to communicate effectively to patients about driving. Most medical professionals express serious concerns about liability regarding return to driving following an injury or surgery. They feel that there is a lack of data to support decisions and inadequate communication among each other. They agree that they must do a better job communicating with patients and their families so they can better prepare for a period of time during their recovery in which they cannot drive. Recent studies published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and the Journal of Foot and Ankle Surgery (JFAS),determined that there are two significant components in the decision of safely returning to driving after an injury or surgery; the time required for healing and the time required for a return of function. Additionally, it was found that those wearing a surgical shoe or walking boot demonstrated a significantly slower braking response time even in healthy/non-injured individuals wearing the shoe/boot.
During the time required for healing, in addition to the fear of an additional trauma from a motor vehicle accident to the healing body part, there is a general concern about the potential damage that may come from over using the body part to drive before it is adequately healed. For example, a healing fracture in the right lower leg might be compromised or delayed if one must suddenly and forcefully apply the brakes. Also, during this time, it is not unusual for post-injury or post-surgery patients to use pain medications, including narcotics. This will also compromise judgment and reaction time while driving.
Most orthopedic conditions heal in 6 to 8 weeks. However, as many of you may fully know, once a cast or splint is removed, you are not ready to run or jump. Depending on the severity of the injury, it may take many weeks of aggressive physical therapy to regain strength, range-of-motion, agility and dexterity to function at a safe level for a full return to daily activities, including driving.
The current research reinforces the fact that driving safely requires good function of the entire body. For example, just because you broke your shoulder bone but did not fracture your right leg does not mean that you are able to drive safely. Wearing a sling after arm surgery also compromises driving. First, the injury must be stabilized and healed before you can drive. Then, you must work in rehab to make modifications to return to safe driving. The same scenario is applied to injuries or surgery to the spine (neck and lower back).
Type of Surgery Time Until Normal Braking*
Knee Arthroscopy 4 Weeks
Right Total Hip Replacement 4-6 Weeks
Right Total Knee Replacement 4-6 Weeks
Lower Leg Fracture 6 Weeks after initial weight bearing
Ankle Fracture 9 Weeks
Right Lower Leg Cast/Brace Full weight bearing after removal of cast/brace
Ankle/Foot Tendonitis/Fasciitis Surgical shoe/boot can be removed for (non-surgical) 50-75% weight bearing
*Based on research using driving simulators
Remember, every case is unique and there is no substitute for communication with your orthopedic surgeon, podiatrist, family physician and physical therapist.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
See all of Dr. Mackarey's content at: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
American Heart Month is not just for lovers. Long after the Valentine’s roses wilt, our hearts will require special attention for a long healthy life. It is the goal of The National Heart, Lung, and Blood Institute to motivate Americans to adopt healthy lifestyles to prevent heart disease. And, in 2021, a healthy heart may be more important than ever to reduce the risk of severe illness from COVID-19.
A recent study by the Center for Disease Control (CDC) found that while many Americans believe that they are “young at heart”, it turns out that many have hearts older than their actual age. For example, the study found that the average American male heart is eight years older and the average American female heart is five years older than their chronological age.
The CDC’s findings may offer some explanation for the fact that many Americans die from heart attacks, strokes, and heart failure when compared to other people around the globe. Furthermore, while more Americans use heart medications more than other people in the world, heart attack and stroke continue to be the leading cause of death in the US, killing more than 80,000 each year.
The CDC has developed a new test to determine “Heart Age,” which has been found to be a much more reliable indicator of a person’s risk for heart disease. The heart age test will determine if your heart is older, younger or average for your age, which can be much more important for longevity than chronological age.
The CDC is encouraging people to take matters into their own hands …be proactive. In addition to calculating your Body Mass Index ((BMI), the CDC is asking people to use an online calculator to determine their heart age. The calculator will give a person a more accurate percentage of risk for heart attack or stroke. Based on the outcome, one must see their family physician or cardiologist to discuss the results and implement a plan.
Heart Age is very easy to use: You just need to enter your age, sex, blood pressure, whether you are treated for high blood pressure, whether you smoke or have diabetes, and your body mass index (BMI), with a handy calculator if you don’t know it. The tool gives you your risk for heart disease in the next ten years, compared with normal.
Visit: www.framinghamheartstudy.org
Enter: sex, blood pressure, (list if controlled), diabetes (list if controlled), smoking history, and body mass index (BMI), a simple height/weight calculation found on-line at www.bmicalculator.cc
Example: A 53 year old women with an acceptable BMI, may actually find that she is at great risk for suffering a heart attack or stroke because she smokes cigarettes and has uncontrolled high blood pressure. The calculator includes all the significant factors proven by science to affect a person’s risk of heart attack or stroke. These include: blood pressure, weight, BMI, blood sugar, cholesterol, age, sex and smoking history.
Example: 50 year old male smoker has uncontrolled high blood pressure of 140/96, no history of diabetes, and a BMI of 30 has a predicted heart age of 72 years. A female with a similar profile would have a heart age of 74 years.
The Solution
To some, the solution may be obvious and for others it may be impossible. In the previous example of the 50 year old smoker, if he quit smoking for one year, he would halve reduced his heart age by 14 years (15 years for a woman). If he would reduce his blood pressure to 120, he would reduce his heart age by 6 years (10 years for a woman). And, if both risk factors were removed, he would reduce his heart age by 19 years (23 for a woman).
In the above examples, the 53 year old man does not have to take his 72 year old heart age as a death sentence.
What Individuals can do…
Require health plans to cover, with limited co pays or deductibles, preventative services such as blood pressure screening nutritional counseling, prescription exercise and tobacco cessation products.
Promote health, wellness through diet and exercise by sponsoring health fairs and establishing bike lanes and walking trails in the community.
Read Dr. Mackarey’s Health & Exercise Forum – Every Monday
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For further inquires related to this topic email: drpmackarey@msn.com
See all of Dr. Mackarey's content at: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
According to The Council for Responsible Nutrition, 77 percent of adults in the United States take dietary supplements. These supplements are available in many forms of pills, capsules, powders, gel tabs, extracts, or liquids. Vitamins and minerals are common supplements and, of these, multivitamins are the most widely consumed. The scientific literature does not support the value or need for supplements, especially for healthy individuals consuming a well-balanced diet. For those with medical problems affecting nutritional absorption, supplements may have merit. However, these over-the-counter products are not regulated by the FDA and for some, may be harmful. Some supplements can interact with your medications. Therefore, before taking any supplements be sure to talk with your medical doctor to be sure it is safe for you. Keep in mind, just because you use herbs for cooking, not all herbs are the same and some can be harmful.
St. John’s Wort is a popular supplement in the USA. It is often used for depression, anxiety and sleep disorders. However, it is not without its side-effects and dangers. Some side effects include: headaches, nausea, dizziness, dry mouth and vulnerability to sunburn. Also, this supplement can be very harmful when taken with some drugs and treatments. Some include; heart medications, antidepressants, birth control pills and chemotherapy treatments
Kava is purported to help with anxiety and insomnia. However, it also may cause liver damage such as hepatitis and should not be taken by those with liver or kidney problems. Kava should not be mixed with alcohol or other drugs that cause drowsiness.
Some believe that Ginkgo can improve memory, circulation, prevent altitude sickness and other scientifically unsupported claims. However, this supplement can thin your blood and cause bleeding. This is especially dangerous if you take blood-thinning medications.
Users claim that oil from this plant can be rubbed into the skin to provide healing from bruising, swelling, and pain. Others take the supplement to help with constipation. However, side effects from Arnica include; high blood pressure, shortness of breath, fast heartbeat and liver damage. In rare cases it has been associated with coma or death.
Ginger is often used to ease nausea associated with motion sickness and chemotherapy. It is also used for joint pain from arthritis. But, as with other supplements, it is not without its problems and can impact; blood clotting, heart rhythms, blood pressure, and blood sugar. Those on blood thinners or have diabetes should be aware.
Goldenseal has a long history as a favorite among Native Americans. Presently, it is used for constipation, colds, eye infections, and cancer. But Goldenseal can affect heart rhythm, blood clotting and lower blood pressure; therefore, if you take blood pressure medication or have clotting issues ask your doctor before taking this supplement.
Aloe, often in the form of a lotion from the plant, has been used on burns or wounds to promote healing and lessen pain. However, when taken by mouth it has been associated with abnormal heart rhythm, kidney problems.
Ephedra has been used for thousands of years in China and India to treat coughs, headaches, and cold symptoms. In contemporary society it has been used for weight loss and to boost energy. But, studies have shown it may increase blood pressure and heart rate and increase the risk of heart problems and stroke. While the FDA has banned ephedra as a supplement, it is still found in some herbal teas.
This supplement is often associated with slowing down the aging process, managing diabetes and improving sexual performance. But, it is also associated with lowering blood sugar (a potential problem for those with diabetes), and thinning blood (a potential problem for those taking blood thinners).
Black cohosh is used to ease menopause symptoms such as hot flashes and night sweats. However, it should not be used by women with liver problems or breast cancer.
This popular supplement is used for high blood pressure and cold symptoms. Some studies support its use to lower cholesterol. While safe for most, garlic can thin your blood and those taking blood thinners must be cautious and seek medical advice.
This supplement has been used for coughs, sore throat, bronchitis, infection, and stomach ulcers. However, licorice root can raise blood pressure and affect heart rhythms so be sure to consult with your physician.
Users believe this supplement has value for allergies, dandruff, bladder stones, and urinary tract infections. But it can also cause fluid retention and should be avoided by those with heart or kidney problems or if taking diuretics.
Feverfew is most commonly used for migraine prevention. It is also used for arthritis joint pain and allergies. But, it is associated with blood clotting and can be problematic for those with heart disease or blood disorders.
In conclusion, while supplements may not be valuable or necessary for healthy individuals, others may find merit. However, these products are NOT regulated by the FDA and may be harmful. Some supplements can interact with your medications. Therefore, before taking any supplements be sure to talk with your medical doctor to be sure it is safe for you.
SOURCES: National Institutes of Health; WebMD
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment.
Read all of Dr. Mackarey's articles at: www.mackareyphysicaltherapy.com/forum
If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
We all know people who complain that they are always cold. Living in NEPA, winter or damp cold fall and spring can make these poor people miserable 6 or more months a year! While it may never feel like Costa Rica, there are options to make our climate more tolerable for those suffering from the cold. Confession: Last year I broke down and bought rechargeable electric ski boot heaters…I LOVE THEM!
While some environmentally conscious folks will think this is a waste of energy, those who suffer from constant chill will feel otherwise. Taking the chill out of your clothes first thing in the morning can set the pace for a nice toasty day. Run them through a short spin just before you get dressed. Your body is usually warmest in the morning, so why not try to keep up the toasty vibe!
Cold temps require more energy demand from your body so you require more fuel to burn to maintain your core body temperature. One hot meal a day with a variety of fruits, vegetables, and other unprocessed foods will serve you well.
Ok, not very sexy, but cold feet don’t cut it either! Wearing socks in bed can help heat your whole body and warm feet can signal your brain that it’s time to go to sleep. If that is the bedtime message you want to send but you don’t want to wear socks then consider wearing warm, fuzzy slippers for a while before bed.
Flannel is not only cozy, but it still breathes so that you won’t get too hot or damp from sweat. Silk is a good second choice to keep you warm, but it might not breathe as well. If you’re really cold, try long underwear and a hat, or “nightcap.”
Iron and B12 are essential to prevent anemia. If you have anemia, you may not have enough red blood cells to take oxygen around your body and that will make you feel chilly. People with poor diets or malabsorption problems may not get enough B12. Pregnant women sometimes have lower levels of iron, because their bodies use more than usual. Sources of B12: chicken, eggs, or fish. Sources of Iron: poultry, pork, seafood, chickpeas, and green leafy vegetables.
Lay it on! Several light layers keep you warmer than a single heavy one. Start with something thin, like thermal underwear that wicks away moisture then add insulation like a wool sweater or down jacket if outdoors. Use a windbreaker as an additional outer shell. Three layers seem to be a sweet spot, but you can adjust. Not warm enough? Add another layer if your too hot, take a layer off.
Also, for those who do not tolerate the cold but love to be outdoors (skiing, ice skating, walking etc) consider some of the new technology. Chemical or rechargeable electric hand and foot warmers, electric heated jackets, vests or shells are also an option.
Electric blankets are OK but can waste heat as heat rises to the ceiling. A heated mattress pad may be a better option. It fits snugly like a sheet and it stays in place.
Do you break a little sweat when you eat too many jalapenos? Spicy food literally warms up your body and maybe something to consider for extra warmth, unless you have stomach problems like ulcers. In fact, a spicy diet can be good for you. Just don’t overdo it!
Space heaters have come a long way to warm smaller areas. Pick a UL-approved unit that fits your space and purpose. A “convection” type with a fan might be best to heat a whole room. A “radiant” model is better to heat a specific spot. Put it on a level surface away from moving people. Keep pets and children away. Plug electric heaters directly into the wall, and look for a safety switch that turns it off when it’s knocked over.
Go for a walk or jog. If it’s too cold outside, hit the gym, or just do some jumping jacks, pushups, or other exercises indoors. Not only will it warm you up, it helps build and keep your muscles strong, which also burn calories and creates body heat. If you’re healthy enough for it, vigorous exercise might even raise your core body temperature.
It can take 2 weeks to adjust to a cold, new environment and may take longer if you are older or have very little body fat. Some medications, like blood thinners or those for allergies or asthma can add to the problem. People who spend lots of time outside often find it easier to get used to sudden changes in temperature
Just because your footwear is insulated doesn’t necessarily mean it’ll keep you warm. Boots that aren’t well sealed from moisture can turn into ice blocks. Look for a high IPX rating. IPX-8 is the highest. It means you could dunk the whole boot in water and your foot would stay dry. And be sure to buy them big enough to fit in some thick wool socks.
Tell your doctor if you’re more sensitive to the cold than in the past. It could be a symptom of a problem with your nutrition, red blood cells (anemia), blood vessels, thyroid gland, or the brain’s thermostat. Try to note how often it happens, how long it lasts, and if it’s getting worse. Your doctor might do some tests to narrow down the cause.
Sources: WebMD
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week – LBP Part II of III
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com/forum.
For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinicalmedicine at GCSOM.
I know that we are all tired of wearing masks. It can be hot, hard to breath and difficult to speak. People feel claustrophobic or confined behind them. Personally, I, too, feel exhausted after a full day in my mask. However, they continue to serve an important role in controlling the spread of COVID … even after we are vaccinated. Evidence has proven that wearing a mask reduces the risk of infection up to 89% and can block 70% of expelled droplets and particles (CDC.org).
Both Pfizer and Moderna vaccines have been released for public use. Many are fearful or wary of them for a variety of reasons. A main concern is that they were “rushed to market.” Last week’s article dispelled many of the myths and concerns the general public is having with the vaccines. The two vaccines have been put under rigorous testing and analysis, more than most vaccines on the market today. Concerns about the vaccines are understandable, but negative outcomes have been few and far between. However, due to the timely release of the vaccines and our inability to examine long-term effectiveness, several factors suggest that wearing a mask will continue to be vital in our fight against COVID-19. Therefore, we will not be shedding our masks anytime soon.
The distribution of the vaccine requires that each vial be frozen at very cold and constant temperatures. As they thaw, they lose effectiveness. Many facilities, especially in the rural parts of the country, do not have the capabilities to properly store the vaccines under the ideal conditions. It will take time to make these vaccine storage facilities safe for COVID vaccines. But fear not, as the details and logistics improve as you read this column, the vaccine will be available to the general public soon!
It is estimated that we need 80% of the population to get vaccinated for the infectious rate to swing in our favor. This means that we need the general public to unite and work as one to fight the spread of the virus. Yes, it is scary taking a new vaccine that has no long-term data, however, with over 1.5 million dead from COVID-19 it seems this is the best option. As a community, we have to band together, trust our science and act in the best interest of all.
Do not have a false sense of the security immediately following your vaccination! Pfizer reports that “it takes a few weeks” and Moderna reports 2 weeks for people to build up an immunity of 50% after the first vaccine. The timeline repeats again after the second vaccine resulting in 95% immunity. During that time, you are still able to contract and spread COVID-19. The use of masks during this time is necessary to keep yourself and others safe.
The clinical trials conducted on the vaccines did not examine if the participants should continue to wear masks. The study only investigated if the individual built up enough antibodies to become immune themselves. Therefore, we do not know if the participants could still be carriers of the virus and continue to infect others that were not vaccinated.
Anthony Fauci, MD, director of the National Institute for Allergy and Infectious Diseases and lead member of the COVID Task Force, recently reported that there is some evidence that the Moderna vaccine may provide a vaccinated individual protection against spreading the virus. However, more time and data are required to confirm these findings.
It is important to remember that many immunosuppressed, autoimmune and pregnant individuals are not suitable for the vaccine. Until we are confident that vaccinated people are not “silent carriers” of the virus, the continued use of a mask is an important measure in protecting the most vulnerable people in our communities.
Until long-term data is available on the vaccines, we do not know how long our immune system will continue to produce antibodies. Antibodies protect us against the virus. This will be monitored as the distribution of the vaccine continues. The good news is, that we have observed individual’s immune system maintain antibodies up to six months in those who recovered from COVID-19. It is expected that the vaccine will at least mimic that immune system response.
There is some light at the end of the tunnel … 2021 will be known as the year that the world took control of COVID-19! We will be shedding our face-protecting cloth companions soon enough. For now, we must wait, stay the course and continue to wear our mask, even after we are vaccinated. As time passes, we will know more about the vaccines and many of the uncertainties in this article will be answered. Until then, mask up, get vaccinated and be safe for yourself and others.
GUEST COLUMNIST: Paul Mackarey, Jr. DPT is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC where he specializes in the prevention and treatment of neck and LBP.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week – LBP Part II of III
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit our website: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at GCSOM.
Visit your doctor regularly and listen to your body.
The New Year brings renewed energy in our collective efforts to win the race against a common foe. If we intend 2021 to be a year of joy and hope — we absolutely need to use all viable tools at our disposal and unite in our efforts to beat the coronavirus. One such tool is vaccines, considered one of the most important advances in modern medicine, and has been responsible for greatly improving our quality of life over centuries. Vaccines have allowed us to triumph over serious adverse diseases by reducing or eliminating many dangerous infectious diseases we don't even think about anymore.
Vaccination research and development has never stopped. Global partnerships have been formed to create faster, more efficient platforms and new technologies to help us against the onslaught of diseases like Ebola, Zika, and the coronavirus family — SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), and now SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).
The victory of vaccines, our most promising counter-pandemic measure, in our fight against a pathogen like SARS-CoV-2, the virus that causes Covid-19, relies on a critical mass of people becoming immune to the virus. This breaks the chain of transmission and, most importantly, protects the most vulnerable people in our community who cannot develop immunity through vaccination. This is called herd immunity — vaccines go beyond our individual benefit; it protects us as a community. Imagine this vaccinated community surrounding a pregnant mother who cannot get vaccinated now; she is protected through this invisible shield of the community blocking SARS-CoV-2 from reaching her.
Vaccine safety requirements are among the highest in the nation because they are widely distributed. Two vaccines (Pfizer/ BioNTech and Moderna) received U.S. emergency use approval (EUA) from the FDA. Nearly 2.8 million people in the U.S. have received a Covid-19 vaccine to date. Dr. Francis Collins, director of the U.S. National Institutes of Health, received the Moderna vaccine on December 22, 2020 — saying the two vaccines had been examined and put through more rigorous analysis than most vaccines to date. Nonetheless, some common myths are surrounding both vaccines:
Both approved U.S. vaccines contain no virus or viral particles. You are not injected with any part of a virus. The vaccines use synthetic messenger RNA (mRNA) that our cells can read to make a specific piece of the virus, which on its own cannot harm. This piece is the protein spikes on the outside of the virus, and it is what helps the virus dock onto a human cell and allows it to infect us. By allowing our cells to reproduce this spike temporarily, we teach our immune system what to look for in the face of a future coronavirus attack. This memory of what to look for provides us immunity and allows us to respond much faster.
The development of the current vaccines did not start in January 2020. Science has been paying close attention to the coronavirus family for many years. Research into the messenger RNA technology used in the Pfizer/ BioNTech and Moderna vaccines has been in development for close to 15 years. The perceived speed in getting the vaccines to the public is partly due to unparalleled worldwide emergency cooperation, free sharing of information, and new faster technology platforms. Also aiding has been billions in private and public funding, allowing vaccine firms to run preclinical and phase I, II, and III trials in parallel instead of sequentially. The FDA completed a meticulous safety review, and the independent Advisory Committee on Immunization panel scrutinized safety and efficacy data from the clinical trials.
Your cell's DNA is securely kept inside a nucleus in the cell. The snippet of mRNA that gets injected does not gain access to the nucleus and never comes in contact with your DNA. Your cell machinery translates the mRNA and manufactures the viral spike protein needed to present to your immune system. Once the instruction is read, human cells break down and get rid of the mRNA.
Currently, we don't have enough information to definitively know how long after infection someone might be protected from getting reinfected with Covid-19. Early indications suggest this natural immunity may not last very long. The CDC recommends getting vaccinated. However, if you are currently infected with Covid-19, the recommendation is to delay vaccination until the illness has resolved.
According to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, getting rid of public health measures like wearing a mask is only possible once there are extremely low levels of circulating virus left. For this to happen, we need 75-95 percent of people to have immunity to the coronavirus.
Both Pfizer/ BioNTech and Moderna have reported that their vaccines contain no preservatives. The vaccines are created using a novel methodology to synthesize the mRNA, encapsulated for protection in a lipid or oily shell. This technology allows the vaccine to be free from materials of animal origin, egg, and without preservatives. However, mRNA is fragile and can break down easily. Storing vaccines in ultracold environments keeps them stable and safe. Vaccines are thawed before injection.
Life and vaccines never present us with absolute safety in usage. We must acknowledge this — vaccines do carry some risks. Of the close to 2.8 million U.S. vaccines to date, very few recipients reported short-term mild or moderate symptoms that resolved without complication within a day or two. These included sore arms, redness at the injection site, headache, chills, fatigue, muscle pain, or fever — all expected indicators that your immune system is responding to the vaccine — and comparable to side effects seen with the shingles vaccine. As of December 23, 2020, the U.S. has seen 10 cases of anaphylaxis. Anaphylactic reactions can occur with any vaccine but are extremely rare. The cases occurred in people with a significant history of severe allergies and were safely managed with epinephrine, and the CDC has distributed safeguard protocols to vaccine sites.
But, compare these calculated vaccination risks to that of the virus itself — which has infected more than 83 million people globally and killed approximately 1.8 million — including more than 350,000 deaths in the United States. Now add in the devastation caused to economies and health systems. Dr. Walter Orenstein, the former director of the United States' National Immunization Program, wrote that if vaccines are not administered to the persons they are recommended for, there is zero impact. In the current pandemic, time is lives. We need an estimated 80 percent of people vaccinated to reach herd immunity to have a fighting chance to stop this pandemic in its tracks — and we need to get it done now.
We face a collective threat — a pandemic, and a moral dilemma on choosing to be vaccinated. Concerns over the vaccines' safety are understandable, but reports on negative outcomes are few and far outweighed by the benefits. This quarantine year has taught me that we are intrinsically bound to our community, only truly to thrive through community involvement and participation. We need each other, and we have an obligation to take care of one another. Getting a Covid-19 vaccine is not just about you; it is protecting your grandmother who has diabetes, your neighbor who is immuno-compromised — it safeguards everyone who is medically unable to receive a vaccine and needs you as their human shield against coronavirus reaching them. Vaccinations save lives — when your eligibility phase comes up, be a solid citizen, loving caring child, sibling, parent, and spouse…GET IT!
This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine.
Author: Hendrik Marais, MD, MS
Hendrik Marais, MD, MS, received his Doctor of Medicine degree from Geisinger Commonwealth School of Medicine in 2015 and his Master of Science degree in Global Medicine from Keck School of Medicine at USC in 2019. He is passionate about creating positive and empowered patient health outcomes. He grew up in South Africa and currently calls Scranton, PA home – where he enjoys cycling, swimming, and discovering the beauty of NEPA. He is a member of the American Medical Association, American Public Health Association, and the International Society of Physical and Rehabilitation Medicine. He plans to pursue a clinical career in physiatry.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
Read all of Dr. Mackarey's articles at https://mackareyphysicaltherapy.com/forum/
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
New Year’s Resolutions are very predictable. While most are health oriented, I purport that a healthy mind, body and spirit requires a healthy lifestyle. Interestingly, the ten most popular resolutions listed below, all have an impact on a healthy life. Moreover, after living with the COVID-19 virus in 2020, perspectives and priorities may have changed for all of us and forever. As such, before any other health tip can be followed, the number one, two and three health tips for 2021 are:
Polls repeatedly show that one of the most consistent resolutions for the New Year is to make more time to spend with family and friends. Moreover, research shows that the comfort and camaraderie of these people whom we love is important to our health and well-being. However, until we are all vaccinated we must do so with great care and precaution; Zoom, FaceTime, phone calls, drive-by visits, outdoor visits or activities, etc. Be Creative and be careful!
The benefits of regular exercise is no longer anecdotal, it is factual. Daily exercise, even in small doses, has been associated with more health benefits than anything else known to man. Studies clearly demonstrate that it reduces cholesterol and coronary artery disease and the risk of some cancers. Also, it increases longevity, helps achieve and maintain weight loss, enhances mood, lowers blood pressure, and even improves arthritis. In short, exercise keeps you healthy and makes you look and feel better. If done properly, there is no down side. So, make this year the year to do it! While a gym may not be the best option for those at risk, buy indoor home equipment or dress appropriately and use Mother Nature for healthy and inspirational walks.
Recent studies report that more than 66 percent of adult Americans are considered overweight or obese. As a result, weight loss is one of the most popular New Year's resolutions. However, adhering to a weight loss program is not easy. It requires many things, including, setting reasonable goals and staying focused. Often, professional help is required. While this may be one of the most difficult goals to attain, the ultimate reward and value is well worth the effort.
Second only to losing weight, this resolution, while extremely difficult, is another life-saving goal that must be attempted. Studies report that smokers try and fail four times on average before they are successful. SO, KEEP TRYING! Get help. Talk to your physician about using over-the-counter or prescription nicotine replacement therapy and proven quit-smoking aids. Consider smoking cessation classes, support groups and hotlines in addition to the meds. This is one goal that is worth the effort.
Due in great part to our hectic and stressful work and family demands, long before COVID-19, the United States is home to millions of people requiring the use of mood elevators and antidepressants. As a result, it is important to learn what really makes you happy in order to FIND YOUR SMILE. It requires the balance of a healthy mind, body and spirit. It might be a walk in the snow, taking virtual dance, exercise or enrichment class. One hint, smiles are often found in something simple and inexpensive. And, be sure to associate with upbeat, fun-loving and genuine people when possible.
This is one tip for a healthier New Year that I expect to receive plenty of flack about! This is especially true now because more alcohol is being consumed with the stress of COVID-19. But, I would be remiss if I did not mention this potentially harmful habit…excessive drinking. While many people use the New Year as an incentive to finally stop drinking, most are unable to adhere to such a rigid goal. Studies show that moderate drinking can offer many health benefits such as lowering cholesterol and coronary artery disease but that is defined as one or two 8 ounce drinks per day and red wine is preferred. However, many heavy drinkers would do well to taper off to a moderate level. For those with a problem and have decided to stop drinking altogether, there are plenty of help and support available such as Alcoholics Anonymous. There are also a number of treatment-based programs, as well as support groups for families of alcoholics.
This is one tip that few consider being health related. However, serious stress from financial problems affects millions of Americans every day. This cumulative stress can be very harmful to your health and can be lessened by initiating a plan. Get professional help and learn how to downsize and reevaluate your real needs. Less toys (adult and child) with less stress for a longer life! For those suffering from economic hardship due to COVID-19, contact social services and government agencies to determine if assistance is available to you and your family.
There may be no one thing more important to gaining a new perspective on life that to have learned something new. It could be as drastic as returning to school to prepare for a career change or as simple as learning to play bridge. Have you vowed to make this year the year to learn something new? Take a virtual course at local college or read a new book. Take a tour of some of the world’s greatest museums. Listen to a TED talk. It will enrich your life and make you a more interesting person. Most local colleges and universities offer virtual and adult education programs
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
Read all of Dr. Mackarey's articles at https://mackareyphysicaltherapy.com/forum/
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
Happy Holidays! It is at this time of year that we celebrate life with great hope and faith. People of many faiths take time to reflect, respect, and resolve. Christians celebrate Christmas, the miraculous birth of Christ, the Son of God, and the Messiah. Jews celebrate Chanukah, the miraculous festival of lights, when one night’s oil provided enough light and safety for 8 nights. Both major faiths promote healthy lifestyles for the mind, body and spirit. These faiths are grounded in hope, faith, love and peace. It is no surprise that studies repeatedly demonstrate that people of faith outlive those without!
With this in mind, I purport, that to be truly healthy, one must have faith because complete health is multidimensional. Socrates preached this message to his students thousands of years before Christ. One must have a healthy mind, which requires intellectual stimulation with attainable goals related to education and intellect. One must have a healthy body by eating well, engaging in physical activity and have attainable goals related to his/her body. Likewise, one must have a healthy spirit with faith, hope, prayer and meditation, comrades and counsel, and set attainable spiritual goals.
1. Healthy Blood Pressure: High blood pressure (hypertension) can lead to heart disease and stroke, which are the leading causes of death in the United States, according to the Centers of Disease Control (CDC). It affects 1 in every 3 adults and only half of these people have their blood pressure under control. Well, religion and spiritually may help …
The health benefits of religion or spirituality are well documented. One study conducted at Duke University Medical Center on 4,000 subjects, older adults who described themselves as religiously active were 40% less likely to have high blood pressure when compared to those less active. Moreover, they were surprised to find that those who described themselves as spiritual rather than religious also were less likely to develop high blood pressure.
2. Greater Sense of Satisfaction: Research also indicates that religious people are more satisfied with their lives than those without faith. A sociology study determined that high satisfaction among church goers may be due to the strong social bonds that are developed within a religious congregation. Regular church attendees see the same people weekly and often more often, when participating in rewarding and gratifying church-related volunteer work.
3. Greater Tolerance for Adversity: In an impressive study published in the Journal of the American Medical Association, researchers interviewed 345 late-stage cancer patients to assess their spirituality as it related to their illness. 88% stated that they were religious as it related to their coping mechanisms. It was determined that those using religion for coping demonstrated a 7.4% rate of resuscitation as compared to 1.8% for those not using religion as a coping mechanism.
4. Stronger Immune System: According to a Duke University study of 1,718 older adult participants, those described as “highly spiritual” were 50% less likely to have high levels of anti-inflammatory proteins that weaken the immune system and have been linked to some cancers, viral infections and autoimmune diseases. The outcome was similar for those who attend religious services at least once a week.
5. Greater Longevity Those who attend religious services more than once per week are found to live and additional 7 years when compared to those who never attend services. Again, researchers feel that the social benefits of a belonging to a strong religious community may be a large part of the associated longevity. Additionally, the lifestyle of religious people is often healthier: members of these communities rarely engage in risky and unhealthy behaviors such as smoking, excessive drinking, indiscriminate sex, etc
Source Health.com
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
Read ALL of Dr. Mackarey's Articles at http://mackareyphysicaltherapy.com/forum/
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
